Roland Jarod L, Price Richard L, Kamath Ashwin A, Akbari S Hassan, Leuthardt Eric C, Miller Brandon A, Smyth Matthew D
Departments of 1 Neurological Surgery.
Brain Laser Center, Washington University School of Medicine in St. Louis, Missouri.
J Neurosurg Pediatr. 2017 Oct;20(4):329-333. doi: 10.3171/2017.5.PEDS1779. Epub 2017 Aug 4.
The authors describe 2 cases of triventricular hydrocephalus initially presenting as aqueductal stenosis that subsequently developed tumors of the pineal and tectal region. The first case resembled late-onset idiopathic aqueductal stenosis on serial imaging. Subsequent imaging revealed a new tumor in the pineal region causing mass effect on the midbrain. The second case presented in a more typical pattern of aqueductal stenosis during infancy. On delayed follow-up imaging, an enlarging tectal mass was discovered. In both cases hydrocephalus was successfully treated by cerebrospinal fluid diversion prior to tumor presentation. The differential diagnoses, diagnostic testing, and treatment course for these unusual cases are discussed. The importance of follow-up MRI in cases of idiopathic aqueductal stenosis is emphasized by these exemplar cases.
作者描述了2例三脑室脑积水病例，最初表现为导水管狭窄，随后发展为松果体和顶盖区肿瘤。第一例在系列成像上类似于迟发性特发性导水管狭窄。后续成像显示松果体区有一个新肿瘤，对中脑产生占位效应。第二例以婴儿期更典型的导水管狭窄模式出现。在延迟随访成像中，发现顶盖区肿块增大。在这两例中，脑积水在肿瘤出现之前通过脑脊液分流成功治疗。讨论了这些不寻常病例的鉴别诊断、诊断测试和治疗过程。这些典型病例强调了在特发性导水管狭窄病例中进行随访磁共振成像的重要性。
